Surgical experiences in South Africa, 1899-1900 : being mainly a clinical study of the nature and effects of injuries produced by bullets of small calibre / by George Henry Makins.

  • Makins, George Henry, Sir, 1853-
Date:
1901
Catalogue details

Licence: In copyright

Credit: Surgical experiences in South Africa, 1899-1900 : being mainly a clinical study of the nature and effects of injuries produced by bullets of small calibre / by George Henry Makins. Source: Wellcome Collection.

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    central point of left ilium ; exit, 1^ inch above the centre of the right Poupart’s ligament. Vomiting commenced soon after the injury, and this was continuous until the patient’s arrival in the Stationary hospital on the fourth day, when the condition was as follows:— Face extremely anxious in expression. Temperature 101°, sweating freely. Pulse 110, fair strength. Tongue moist. Abdomen much distended, rigid, motionless, tympanitic through- out. Bowels confined. Xo urine had been passed for twenty-four hours, 5ij in bladder on catheterisation, clear, and containing no blood. Abdominal section. Median incision. A considerable quantity of bloody effusion was evacuated. Intestine generally congested and distended. Xo lymph. Two wounds were found in the ileum on the opposite sides of one coil; the openings were circular, with the mucous membrane everted. Xo escape of faecal matter was visible until the intestine was delivered, when intestinal contents spurted freely across the room. The openings were sutured with five Lembert’s stitches. The bowel was punctured in two places to relieve distension, and then returned into the belly, after washing with boiled water. Four pints of saline solution were infused into the median basilic vein, and gi’ain strychnine sulph. was injected hypo- dermically. The patient did not rally, and died twelve hours after the operation. (167^) Mounded at Graspan. Entry (Lee-Metford), midway between the umbihcus and pubes; exit, 1 inch to the left of the fifth lumbar spine. The patient was seen on the third day in the following condition : in great pain, expression extremely anxious, vomiting constantly. Pulse 150 running, respirations 48. Tem- perature 100°, sweating freely. Great distension, rigidity, and general tenderness of immobile abdomen. Xo improvement followed the administration of brandy and hypodermic injection of strychnine gi’ain, and operation was deemed hopeless. In the evening the patient was apparently dying. .Face blue and sunken and covered with sweat, eyes dull, speechless, pulse imperceptible, restlessness extreme, bowels acting involuntarily, no urine in bladder. The man was placed m a tent by himself, and to my surprise was alive and better the next morning; the expression was still anxious, but the face brighter and not sweating; the pulse only